<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="" autocomplete="off">
   <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name_n')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="required" class="form-control"   name="row[name]" type="text" >
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tel" data-rule="required" class="form-control"  name="row[tel]" type="text" >
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Area_s')}:</label>
        <div class="col-xs-12 col-sm-8">
        {:Form::cxselect('ajax/area', ['province','city','area'])}
        </div>
    </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address"  class="form-control form-control" name="row[address]" type="text" >
        </div>
    </div>     
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('School')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-school"  class="form-control form-control" name="row[school]" type="text" >
        </div>
    </div>  
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Grade')}:</label>
        <div class="col-xs-12 col-sm-8">
         <select  id="c-grade" data-rule="required" class="form-control selectpicker" name="row[grade]">
                {foreach name="getGradeList" item="vo"}
                    <option value="{$key}"  {in name="key" value=""}selected{/in}>{$vo}</option>
                {/foreach}
          </select>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Source')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-source" data-rule="required" class="form-control" name="row[source]" type="text" >
        </div>
    </div> 
  {if AdminAuth('finance/extract/week/important')}
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Message_status')}:</label>
        <div class="col-xs-12 col-sm-8">
             {:build_radios('row[message_status]', ['1'=>__('Message_status 1'), '2'=>__('Message_status 2')])}
        </div>
    </div>   
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Message_num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-message_num"  class="form-control" disabled  type="text"> 
        </div>
    </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Receive')}:</label>
        <div class="col-xs-12 col-sm-8">
             {:build_radios('row[receive]', ['1'=>__('Receive 1'), '2'=>__('Receive 2')])}
        </div>
    </div> 
   {/if}
   
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
